Factors Related to the Diagnostic Yield of Flexible Bronchoscopy without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Kang, Hye Seon; Ha, Jeonghoon; Kang, Hyeon Hui; Yeo, Chang Dong; Rhee, Chin Kook; Kim, Sung Kyoung; Moon, Hwa Sik; Lee, Sang Haak

doi:10.4046/trd.2017.80.3.284

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Using published data 3 , we reviewed only the reported results for the final diagnosis of peripheral lung cancer during non-guided FB up to 2018 (Table 3). Of nine studies, washing was performed together with TBB in five 8,[11][12][13][14] , before TBB or brushing in three 12,13,15 , and after other procedures in two studies 8,11 . The average diagnostic yields of brushing and washing from the literature review were 19.6% (range 12.6-31.4%) and 24.4% (range 5.9-50.9%), respectively.…”

Section: Discussionmentioning

confidence: 99%

The optimal sequence of bronchial brushing and washing for diagnosing peripheral lung cancer using non-guided flexible bronchoscopy

Lim

Kim

Jeon

et al. 2020

Sci Rep

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The optimum sequence of bronchial brushing and washing for diagnosing peripheral lung cancer, defined as an invisible endobronchial tumour, is not clear and requires further study. We prospectively obtained washing samples after brushing in patients with peripheral lung tumours during non-guided flexible bronchoscopy (FB) to investigate the diagnostic yield of these samples and conducted a retrospective review of the prospectively collected data. The study included 166 patients who met the inclusion criteria. The overall diagnostic yield of bronchial brushing and washing for peripheral lung cancer was 52.4%. The diagnostic yields of brushing and washing were 37.3% and 46.4%, respectively, and that of washing was superior according to McNemar's test (p = 0.017, κ = 0.570). Furthermore, washing was diagnostic, whereas brushing was not, in 15.1% of all cases. Comparison of positive washing cytology (brushing) with the respective pathological diagnosis yielded a concordance rate of 88.3% (90.3%), with κ = 0.769 (0.801) (p < 0.001). Performing washing after brushing during nonguided FB is a very safe, cost-effective procedure that may help improve the diagnostic yield in patients with suspected peripheral lung cancer. Our information will also benefit clinicians performing diagnostic bronchoscopy in patients with suspected peripheral lung cancer when fluoroscopic guidance or advanced bronchoscopy techniques are not available. Flexible bronchoscopy (FB) is an essential step in the diagnosis of lung cancer. Numerous basic diagnostic procedures using FB, including bronchoalveolar lavage or washing, brushing, endobronchial or transbronchial biopsy (TBB), and transbronchial needle aspiration, have been evaluated in various combinations to improve the diagnostic yield of FB in patients with suspected lung cancer 1-3. The diagnostic yield of bronchoscopy for lung cancer depends on whether the tumor is visible within the bronchial tree. The overall sensitivity of FB among many studies of central tumours, defined as visible endobronchial tumours, was 88% (range 67-97%). The sensitivities of endobronchial biopsy, brushing, and washing were 74% (range 48-97%), 61% (23-93%), and 47% (29-78%), respectively. In comparison, the overall sensitivity of FB for peripheral lung cancer, defined as an invisible endobronchial tumour, was 78% (range 36-88%). TBB had the highest sensitivity (57%, range 17-80%), followed by brushing (54%, range 16-84%), and bronchoalveolar lavage or washing (43%, range 12-65%) 3. However, the

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Section: Discussionmentioning

confidence: 99%

The optimal sequence of bronchial brushing and washing for diagnosing peripheral lung cancer using non-guided flexible bronchoscopy

Lim

Kim

Jeon

et al. 2020

Sci Rep

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“…Our research suggested that lesion 2cm (p = 0.042) and the bronchial generation of lesion ≤ 5th generation (p = 0.005) could affect the diagnostic yields of HBM-EBUS-TBLB, as shown in the multivariate analysis. Previous studies showed that a bronchus sign on CT [21] , pathology [22,23] , non-upper lobe location, tobacco use and peripheral transbronchial needle aspiration [24] independently correlated with improved diagnostic yield. However, we found that the impact of the diagnosis yield by HBM-EBUS-TBLB was depended on two factors: lesion characters and lesion location.…”

Section: Discussionmentioning

confidence: 97%

Improvements to diagnosis peripheral lung lesions with a hand- drawn bronchial map: a cohort study

Zhou

Duan

et al. 2023

Preprint

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Peripheral lung lesions (PLLs) have become common findings in routine medical practice. To evaluate whether the hand-drawn bronchial map (HBM) can increase the diagnostic yield of bronchoscope for PLLs. A study on the evaluation of this method for the diagnosis of PPLs was conducted on patients from January 2020 to December 2020 in the Department of Respiratory Medicine, Zhejiang Provincial People’s Hospital. Patients who underwent transbronchial lung biopsy (TBLB) with HBM were included in the HBM group and enrolled into the NHBM group without HBM. A total of 105 patients were included. 71 patients were in the HBM group and 34 patients were in the NHBM group. Overall, 61 (61.62%) of the confirmed lesions were malignant and adenocarcinoma was the main type. 38 (38.38%) lesions were benign. The overall determined diagnostic yield of benign lesions and malignant lesions was no significant difference (P = 0.101). When lesion > 20 mm and ≤ 30 mm, the diagnostic yield in HBM group was significantly higher than that in NHBM group (80.77% vs 45.45%, p=0.032). Compared to the NHBM group, endobronchial ultrasound (EBUS) detection rate in the HBM group had significantly higher diagnostic yield (83.1% vs 58.82%, p=0.007). Multivariate analysis showed that only lesion > 2cm and the bronchial generation of lesion ≤ 5th generation affected diagnostic yield. A hand-drawn bronchial map with high convenience and low cost greatly increases EBUS detection rate and diagnostic yield of bronchoscope for PPLs.

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“…Both procedures have their own advantages, and FLB has the benefit of avoidance of general anaesthesia, easyto-use instruments, and widespread availability. However, the failure rate of FLB is not negligible, especially when the diagnosis is delayed and in cases of peripherally located FBs [5][6][7]. Difficulty in maintaining airway patency can be a challenge, and complete cooperation of the patient is essential for the procedure.…”

Section: Introductionmentioning

confidence: 99%

Rigid Bronchoscopy: A Life-Saving Intervention in the Removal of Foreign Body in Adults at a Busy Tertiary Care Unit

Mazcuri¹,

Ahmad²,

Shaikh³

et al. 2020

Cureus

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Factors Related to the Diagnostic Yield of Flexible Bronchoscopy without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

Cited by 3 publications

References 29 publications

The optimal sequence of bronchial brushing and washing for diagnosing peripheral lung cancer using non-guided flexible bronchoscopy

The optimal sequence of bronchial brushing and washing for diagnosing peripheral lung cancer using non-guided flexible bronchoscopy

Improvements to diagnosis peripheral lung lesions with a hand- drawn bronchial map: a cohort study

Rigid Bronchoscopy: A Life-Saving Intervention in the Removal of Foreign Body in Adults at a Busy Tertiary Care Unit

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